Provider Enrollment Representative

Job Description

Initiates and processes faculty practice provider enrollments/re-enrollments including, but not limited to preparing, sending and receiving related correspondence; assisting in resolving denials or rejections; ensuring proper payment; providing related information to Information Systems.

Job Responsibility

• Initiates and tracks enrollment and re-enrollment for new faculty practice providers with government and faculty practice contracted managed care carriers.
• Prepares, sends, and receives correspondence to providers, clinical department personnel, managed care/government carriers and others to obtain required credentialing information for government/managed care enrollment.
• Assists the System FPP business office in resolving provider related denials and rejections, and ensures proper payment for services.
• Communicates billing provider numbers and effective dates to the FPP Information Systems to ensure the billing system is updated.
• Performs related duties as required. All responsibilities noted here are considered essential functions of the job under the Americans with Disabilities Act. Duties not mentioned here, but considered related are not essential functions.

Job Qualification

• High School Diploma or equivalent required.
• 1-3 years of relevant experience, required.
• Additional Salary Detail

The salary range and/or hourly rate listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future.When determining a team members base salary and/or rate, several factors may be considered as applicable (e.g., location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget and internal equity).